DESCRIPTION: This is a FIRST award application for research on adherence and adjustment in renal dialysis patients. The research proposal has two phases. In Phase I, the investigator will identify patient psychological attributes that interact with dialysis type to determine patient adherence and adjustment. It is predicted that adjustment and adherence will vary as a joint function of the type of dialysis prescribed and patient coping style. For example, patients who possess a more active style of coping should exhibit more favorable adherence when undergoing a self-administered dialysis treatment modality (i.e., continuous ambulatory peritoneal dialysis-- CAPD) but poorer adherence when receiving staff-administered dialysis (i.e., center hemodialysis). A longitudinal research design will be used in Phase I to allow for a prospective test of the interactive hypotheses over a 12-month period. The second phase of the research addresses the effectiveness and feasibility of psychological intervention. Two studies will be conducted, one with hemodialysis patients and the second with CAPD patients. The experiments will examine the interactive effects of self-management training and patient psychological attributes (e.g., coping style). Intervention protocols will consist of conventional procedures widely used by behavioral psychologists and designed to be implemented in a small-group format. The knowledge generated will provide both empirical data and a theoretical framework clinicians can draw upon when making treatment decisions in regard to ESRD and other medical populations.